The document is an application form for the National Outdoor Leadership School's Trip Leader Course in India. It requests basic contact information from applicants, as well as emergency contact details. Applicants must agree to the course description, objectives, terms and conditions. The course runs from October 19th to November 8th, 2010 and costs 36,000 rupees total. Payment is due in two installments and can only be made via bank transfer or credit card. Admission is contingent on submitting all required forms and full payment. Students may be expelled for unsafe, disruptive or unethical behavior. Refund policies for cancellation are outlined.

1. National Outdoor Leadership School
India
Trip Leader Course Application Form
Name
Surname Name Preferred Name
Address Work: Residence
Phone-Work _____ _______ Residence ______
Fax ___________________________________ e-mail __ _______ _______
Mailing Preference: send all correspondence to: Work Home (circle one)
Gender : M F Age____ Birth date_____________________
Height __________ Weight ____________
Are you a student or employed? Describe briefly ______________________________________________________
How did you hear about this course?
Person To Notify In Case Of Emergency:
Name Relationship to Applicant
Address
__________ Phone____________________
I have read and understand the course description and course objectives of this Trip Leader Course, accept and agree
with the terms and conditions mentioned overleaf. I understand that I am not accepted on my course until the medical
form and assumption of risk form has been received and approved. I give permission for NOLS India to use my name,
address and picture in promotional materials and press releases.
Kindly include a recent photograph of yourself with this application form.
SIGNATURE OF PARTICIPANT: Date
Course Date: 19th October – 8th November 2010
Course fee: Rs. 36.000/- (Ex -Ranikhet)
Total to be paid: Rs. 36000/- (US $ 800)
Registration fee: Rs. 16000/- (US $ 300)
Balance fee: Rs. 20000/- (US $ 500)
NOLS will accept payment only through bank transfer or Credit Card Payment, Please contact NOLS India Program
Office for Details, you could reach our office via email- ravi_kumar@nols.edu or call +91 5966 221428

2. Terms and Conditions-Trip Leader Course
Admission:
NOLS India seeks students who are motivated to learn, are in good health and are physically, mentally and socially
responsible. Final acceptance is based upon the full payment of course fees, receipt and review of the forms listed.
Student behavior and discipline:
NOLS India will expel any student who exhibits behavior that is unsafe or disrupts or distracts from the educational
mission of the course. Harassment, use of drugs or alcohol, theft or misuse of property, low motivation and disagreeing
instructions are examples of behavior that will lead to expulsion.
Refund and cancellation:
If you do not pay the balance of the course fees 45 days before the course begins, your admission will be cancelled and
NOLS India will retain your registration fee. There will be no refund.
If you cancel 30 days before the course begins, NOLS India will retain the registration fee.
If you cancel 15 days before the course begins, NOLS India will retain 50 % of the course fee.
If you cancel less than 14 days before the course begins, or, are not present when the course begins, there will be no
refund.
Although there is rarely the need to do so, NOLS India reserves the right to cancel a course or change a course duration,
tuition or location.
Student Questionnaire:
What are your personal or professional objectives for this course?
Briefly describe your outdoor/camping experience and skill level:
Briefly describe your teaching experience, if any: (age groups, indoor-outdoor, subjects taught, etc.):
E-MAIL OR POST COMPLETED APPLICATION TO:
NOLS India
‘Vaniya Cottage’ Mall Road,
Ranikhet 263645
Uttaranchal
Tel: (05966) 221428
E-mail: ravi_kumar@nols.edu